Most smokers relapse within three months of treatment. U researchers found they could help more folks stay smoke-free with frequent phone nudges.

Jeff Wheeler, Star Tribune

Ron Roloff and Kristi Kittelson visited while they smoked on the sidewalk in front of HCMC in Minneapolis. Said Kittelson: “Every time I see my doctor, which is once a month, he nags me to quit.”

Jeff Wheeler, Star Tribune

Nagging vs. smoking

Article by: MAURA LERNER

Star Tribune

November 28, 2011 - 9:04 PM

You won't find the word "nagging" in the study.

But scientists at the University of Minnesota have found that smokers are more likely to kick the habit if a counselor calls them every month for a year with helpful tips and nicotine patches.

Typically, stop-smoking programs only last about eight weeks. But Dr. Anne Joseph, a professor of medicine, and her colleagues found that they could boost the success rate as much as 75 percent by extending treatment to 12 months.

As part of the program, counselors stayed in touch with patients for a full year, calling some patients as many as 50 times. The counselors adopted what they called a "chronic disease" model of care, which meant they didn't give up if the smoker relapsed.

They encouraged smokers to keep trying and gave them the option of cutting back on tobacco use if they were unwilling to give it up completely -- at least as a first step.

"You could call it nagging," said Joseph, "but we prefer to call it ... persistent. We were very persistent."

In the end, 30.2 percent of the experimental group gave up smoking for six months or more -- the benchmark of success -- compared to 23.5 percent in the conventional program.

It's common knowledge that stop-smoking programs have high failure rates.

"Unfortunately, most smokers relapse within three months of treatment," Joseph and her colleagues noted in the study, which was published Monday in the Archives of Internal Medicine.

In this case, Joseph said, they tried to mimic the treatment plans for chronic conditions such as diabetes or high blood pressure. That means working with patients over time, adjusting their medications and offering encouragement to keep trying.

"We would ramp up the phone calls to do what we call relapse-sensitive calling," Joseph said, especially for the first week of abstinence, when smokers are most vulnerable to relapse.

"Some people got really lots and lots of calls."

Of course, the counselors tried to be more sensitive than, say, a nagging parent. "It was intentionally non-judgmental," Joseph said. "And that's probably the big difference between a mom and a counselor."

On average, the more intense program cost $944 per person, about twice the cost of the eight-week program. But when the researchers adjusted for differences in the two study groups, they found the experimental program was 75 percent more effective at getting smokers to quit long-term.

"I think the take-home message," Joseph said, "is that if a person wants to quit smoking ... they just have to keep going at it and tweaking their treatment until they achieve that goal."